Jason Kevin Brooks, LCSW

Individual provider Active NPI Clinical Social Worker · Powder Springs, GA

NPI 1558053223 · NPPES record last updated May 22, 2023

Key facts

NPI
1558053223
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
CSW007859 (GA)
Practice address
4299 Maclaren CT
Powder Springs, GA 30127-1799
Phone
(404) 857-2877
Fax
(404) 857-2877
NPI assigned
May 22, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CSW007859GAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X CSW007859 GA Yes

Addresses

Primary practice location

4299 Maclaren CT
Powder Springs, GA 30127-1799

Mailing address

4299 Maclaren CT
Powder Springs, GA 30127-1799
Phone (404) 857-2877

Other providers in Powder Springs, GA

All providers in Powder Springs, GA · Clinical Social Worker in Georgia

Sources for this page

Verify at the official NPI Registry.